Do Patients Have a Right to Understand the EHR?

A Kentucky electrophysiologist created a satirical post recently that positioned the EPIC EHR as a computer game. Screenshots of platform were used and he was subsequently forced to remove the images. Wes Fisher caught the story and has the necessary links. While I didn’t feel that the original post was nearly as clever as it was provocative and snarky, Wes’ pithy analysis broaches some interesting questions about EPIC’s response. More important than the specifics of this type of public dialog is what’s behind it all.

For me, there’s a broader question that I find interesting: Do patients have a right to see and understand the EHR that their doctors are using to facilitate their care? And if the patients were to experience a mainstream EHR first hand, how would providers be seen differently? How would patient advocates see meaningful use?

It’s not a crazy question. Physicians are often criticized for their attention to the second screen. And the failure to properly shift our focus from the EHR is always on the head of the doctor. Yet we never consider the experience of this individual who’s legally and ethically responsible for the collection of the patient’s story.

What if e-Patient Dave were put in the drivers seat of the provider with EPIC? What if Kerri Sparling were forced to sit and enter her story in Cerner? And what if it were onstage and live streamed at HIMSS or Medicine X? It shouldn’t be complicated. They know their story better than any doctor.

No satire. Just real people showcasing a user interface.

I suspect that it might lead to an interesting and very contagious public conversation surrounding EHRs and the responsibility of those who create them.

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Bryan Vartabedian, MD

Bryan Vartabedian is a pediatrician at Baylor College of Medicine/Texas Children's Hospital and one of health care’s influential voices on technology and medicine. 33 charts is a sandbox for his evolving ideas.